Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wise Cleft Center for Excellence LLC

Organization Plastic Surgery Physician · NPI 1588407142

Wise Cleft Center for Excellence LLC is a Plastic Surgery Physician in Draper, Utah. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11762 S State St Ste 110
Draper, UT 84020-7158
Phone: (385) 977-8125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1588407142
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gavin Lawrence — Director Of Development · (435) 669-7660
NPI enumeratedJune 13, 2024
Last updated in NPPESFebruary 20, 2025
Certification dateFebruary 20, 2025
Mailing address11762 S State St Ste 110, Draper, UT 84020-7158

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